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Multisector community partnerships (MCPs) are key component of the public health strategy for addressing social determinants of health (SDOH) and promoting health equity. Governmental public health agencies are often members or leaders of MCPs, but few studies have examined the role of health departments in supporting MCPs' SDOH initiatives. We engaged 42 established MCPs in a rapid retrospective evaluation to better understand how MCPs' SDOH initiatives contribute to community changes that promote healthy living and improved health outcomes. As part of this work, we gained insights into how health departments support MCPs' SDOH initiatives, as well as opportunities for enhanced collaboration. Results indicate that health departments can support MCPs' SDOH initiatives through the provision of funding and technical assistance, data sharing, and connecting community organizations with shared missions, for example. Findings can be used to inform the development of funding opportunities and technical assistance for MCPs and health department partners.

Rising daily temperatures and water shortage are two of the major concerns in agriculture. In this work, we analysed the tolerance traits in a tomato line carrying a small region of the Solanum pennellii wild genome (IL12-4-SL) when grown under prolonged conditions of single and combined high temperature and water stress. When exposed to stress, IL12-4-SL showed higher heat tolerance than the cultivated line M82 at morphological, physiological, and biochemical levels. Moreover, under stress IL12-4-SL produced more flowers than M82, also characterized by higher pollen viability. In both lines, water stress negatively affected photosynthesis more than heat alone, whereas the combined stress did not further exacerbate the negative impacts of drought on this trait. Despite an observed decrease in carbon fixation, the quantum yield of PSII linear electron transport in IL12-4-SL was not affected by stress, thereby indicating that photochemical processes other than CO2 fixation acted to maintain the electron chain in oxidized state and prevent photodamage. The ability of IL12-4-SL to tolerate abiotic stress was also related to the intrinsic ability of this line to accumulate ascorbic acid. The data collected in this study clearly indicate improved tolerance to single and combined abiotic stress for IL12-4-SL, making this line a promising one for cultivation in a climate scenario characterized by frequent and long-lasting heatwaves and low rainfall.

Full list of authors: Jorstad, S. G.; Marscher, A. P.; Raiteri, C. M.; Villata, M.; Weaver, Z. R.; Zhang, H.; Dong, L.; Gomez, J. L.; Perel, M., V; Savchenko, S. S.; Larionov, V. M.; Carosati, D.; Chen, W. P.; Kurtanidze, O. M.; Marchini, A.; Matsumoto, K.; Mortari, F.; Aceti, P.; Acosta-Pulido, J. A.; Andreeva, T.; Apolonio, G.; Arena, C.; Arkharov, A.; Bachev, R.; Bonnoli, G.; Borman, G. A.; Bozhilov, V; Carnerero, M., I; Damljanovic, G.; Ehgamberdiev, S. A.; Elsasser, D.; Frasca, A.; Gabellini, D.; Grishina, T. S.; Gupta, A. C.; Hagen-Thorn, V. A.; Hallum, M. K.; Hart, M.; Hasuda, K.; Hemrich, F.; Hsiao, H. Y.; Ibryamov, S.; Irsmambetova, T. R.; Ivanov, D., V; Joner, M. D.; Kimeridze, G. N.; Klimanov, S. A.; Knoett, J.; Kopatskaya, E. N.; Kurtanidze, S. O.; Kurtenkov, A.; Kuutma, T.; Larionova, E. G.; Leonini, S.; Lin, H. C.; Lorey, C.; Mannheim, K.; Marino, G.; Minev, M.; Mirzaqulov, D. O.; Morozova, D. A.; Nikiforova, A. A.; Nikolashvili, M. G.; Ovcharov, E.; Papini, R.; Pursimo, T.; Rahimov, I; Reinhart, D.; Sakamoto, T.; Salvaggio, F.; Semkov, E.; Shakhovskoy, D. N.; Sigua, L. A.; Steineke, R.; Stojanovic, M.; Strigachev, A.; Troitskaya, Y., V; Troitskiy, I. S.; Tsai, A.; Valcheva, A.; Vasilyev, A. A.; Vince, O.; Waller, L.; Zaharieva, E.; Chatterjee, R., Blazars are active galactic nuclei (AGN) with relativistic jets whose non-thermal radiation is extremely variable on various timescales1,2,3. This variability seems mostly random, although some quasi-periodic oscillations (QPOs), implying systematic processes, have been reported in blazars and other AGN. QPOs with timescales of days or hours are especially rare4 in AGN and their nature is highly debated, explained by emitting plasma moving helically inside the jet5, plasma instabilities6,7 or orbital motion in an accretion disc7,8. Here we report results of intense optical and γ-ray flux monitoring of BL Lacertae (BL Lac) during a dramatic outburst in 2020 (ref. 9). BL Lac, the prototype of a subclass of blazars10, is powered by a 1.7 × 108 MSun (ref. 11) black hole in an elliptical galaxy (distance = 313 megaparsecs (ref. 12)). Our observations show QPOs of optical flux and linear polarization, and γ-ray flux, with cycles as short as approximately 13 h during the highest state of the outburst. The QPO properties match the expectations of current-driven kink instabilities6 near a recollimation shock about 5 parsecs (pc) from the black hole in the wake of an apparent superluminal feature moving down the jet. Such a kink is apparent in a microwave Very Long Baseline Array (VLBA) image. © 2022 Springer Nature Limited., The research reported here is based on work supported in part by US National Science Foundation grants AST-2108622 and AST-2107806, and NASA Fermi GI grants 80NSSC20K1567, 80NSSC21K1917 and 80NSSC21K1951; by Shota Rustaveli National Science Foundation of Georgia under contract FR-19-6174; by the Bulgarian National Science Fund of the Ministry of Education and Science under grants DN 18-10/2017, DN 18-13/2017, KP-06-H28/3 (2018), KP-06-H38/4 (2019) and KP-06-KITAJ/2 (2020), and by National RI Roadmap Project D01-383/18.12.2020 of the Ministry of Education and Science of the Republic of Bulgaria; by JSPS KAKENHI grant #19K03930 of Japan; by the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract 451-03-9/2021-14/200002) and observing grant support from the Institute of Astronomy and Rozhen NAO BAS through the bilateral joint research project ‘Gaia Celestial Reference Frame (CRF) and fast variable astronomical objects’; by the Agenzia Spaziale Italiana (ASI) through contracts I/037/08/0, I/058/10/0, 2014-025-R.0, 2014-025-R.1.2015 and 2018-24-HH.0 to the Italian Istituto Nazionale di Astrofisica (INAF). H.Z. is supported by the NASA Postdoctoral Program at Goddard Space Flight Center, administered by ORAU. M.V.P. is partially supported by the Russian Foundation for Basic Research grant 20-02-00490. G.B. acknowledges support from the State Agency for Research of the Spanish MCIU through the ‘Center of Excellence Severo Ochoa’ award to the Instituto de Astrofísica de Andalucía (SEV-2017-0709) and from the Spanish ‘Ministerio de Ciencia e Innovacíon’ (MICINN) through grant PID2019-107847RB-C44. M.D.J. thanks the Brigham Young University Department of Physics and Astronomy for continued support of the extragalactic monitoring programme under way at the West Mountain Observatory. R.C. thanks ISRO for support under the AstroSat archival data utilization programme and BRNS for support through a project grant (sanction no. 57/14/10/2019-BRNS). The measurements at the Hans Haffner Observatory, Hettstadt, Germany, were supported by Baader Planetarium, Mammendorf, Germany. This study was based (in part) on observations conducted using the 1.8-m Perkins Telescope Observatory (PTO) in Arizona, USA, which is owned and operated by Boston University. These results made use of the Lowell Discovery Telescope (LDT) at Lowell Observatory. Lowell Observatory is a private, non-profit institution dedicated to astrophysical research and public appreciation of astronomy, and operates the LDT in partnership with Boston University, the University of Maryland and the University of Toledo. This paper is partly based on observations made with the IAC-80 operated on the island of Tenerife by the Instituto de Astrofisica de Canarias in the Spanish Observatorio del Teide and on observations made with the LCOGT telescopes, one of whose nodes is located at the Observatorios de Canarias del IAC on the island of Tenerife in the Observatorio del Teide. This paper is partly based on observations made with the Nordic Optical Telescope, owned in collaboration by the University of Turku and Aarhus University, and operated jointly by Aarhus University, the University of Turku and the University of Oslo, representing Denmark, Finland and Norway, the University of Iceland and Stockholm University at the Observatorio del Roque de los Muchachos, La Palma, Spain, of the Instituto de Astrofisica de Canarias. The VLBA is an instrument of the NRAO, USA. The NRAO is a facility of the National Science Foundation operated under cooperative agreement by Associated Universities, Inc.

Introduction Diabetes and obesity pose a significant burden for the U.S. military beneficiary population, creating a great need to provide evidence-based diabetes and obesity prevention services for military personnel, retirees, and their dependents. Despite increasing dissemination of the Diabetes Prevention Program (DPP) lifestyle intervention nationwide, formal evaluation of implementation of this highly successful program is limited in the military setting. The purpose of this study is to prospectively evaluate delivery of a direct adaptation of a 1-year DPP lifestyle intervention at a U.S. Air Force medical facility, Wright-Patterson Medical Center (WPMC), to determine the feasibility of delivery of the program in a group of at-risk active duty military, retirees, and family members, as well as assess effectiveness in improving weight and other risk factors for type 2 diabetes. Materials and Methods A pre/post study design was utilized to evaluate feasibility and effectiveness of the DPP Group Lifestyle Balance (GLB), an up-to-date, 22-session direct adaptation of the DPP curriculum, at WPMC. Participants chose to complete the 1-year program either in coach-led face-to-face groups or via DVD with weekly telephonic coach contact. The study was approved by the University of Pittsburgh and WPMC Institutional Review Boards. Results A total of 99 individuals enrolled in the study, with 83 (84%) and 77 (78%) completing 6- and 12-month follow-up assessments, respectively. The mean age of participants at baseline was 57 (range 20-85 years), with 63% being female. The group was comprised of individuals who were non-Hispanic White (73.7%), non-Hispanic Black (18.2%), and other race or Hispanic ethnicity (8.1%). Within this group, there were 10 active duty military, 37 retirees, and 52 family members. The DPP-GLB program was shown to be feasible to implement in this military healthcare setting as demonstrated by the high engagement over the course of the year-long program. Significant improvements were shown in the two main behavioral goals: mean weight (−12.8 lbs, −6.3%, P Conclusions These results demonstrate that the DPP-GLB program delivered via face-to-face groups or DVD was feasible and effective in improving weight, PA levels, and diabetes and cardiovascular risk factors in this group of active and retired military personnel and their family members. The program was well received by the program participants as well as the WPMC team. These findings offer a model for provision of the DPP-GLB program throughout the Military Health System.

In 2021 BL Lacertae underwent an extraordinary activity phase, which was intensively followed by the Whole Earth Blazar Telescope (WEBT) Collaboration. We present the WEBT optical data in the BVRI bands acquired at 36 observatories around the world. In mid 2021 the source showed its historical maximum, with R = 11.14. The light curves display many episodes of intraday variability, whose amplitude increases with source brightness, in agreement with a geometrical interpretation of the long-term flux behaviour. This is also supported by the long-term spectral variability, with an almost achromatic trend with brightness. In contrast, short-term variations are found to be strongly chromatic and are ascribed to energetic processes in the jet. We also analyse the optical polarimetric behaviour, finding evidence of a strong correlation between the intrinsic fast variations in flux density and those in polarisation degree, with a time delay of about 13 h. This suggests a common physical origin. The overall behaviour of the source can be interpreted as the result of two mechanisms: variability on time scales greater than several days is likely produced by orientation effects, while either shock waves propagating in the jet, or magnetic reconnection, possibly induced by kink instabilities in the jet, can explain variability on shorter time scales. The latter scenario could also account for the appearance of quasi-periodic oscillations, with periods from a few days to a few hours, during outbursts, when the jet is more closely aligned with our line of sight and the time scales are shortened by relativistic effects., Comment: 15 pages, 16 figures, submitted to MNRAS

Despite the wealth of information on biomarkers of diabetes complications in adults with type 1 diabetes, data in the pediatric population is limited. Diabetic nephropathy (DN), the leading cause of mortality in type 1 diabetes T1D), could be potentially missed in youth, as albuminuria, the current “gold” standard, may be transient and may not reflect permanent renal impairment. Soluble alpha KL has emerged as a potential marker of early diabetic nephropathy. Seventy-nine pediatric patients with type 1 diabetes meeting ISPAD criteria for nephropathy screening were consecutively recruited (90% Caucasian, 51% male, mean age 16.1 ± 3.1 years, duration of T1D 7.2 ± 3.9 years, 2-year average HbA1c 8.0 ± 1.3%, and serum and urine samples were collected for analysis. Serum Klotho (KL) and circulating miRNA levels of select miRNA involved in the pathogenesis of DN were estimated. KL had a strong inverse correlation with diabetes duration and HbA1c, two important risk factors in the development of diabetes complications. Serum miR-192 were negatively associated with KL among children with prolonged duration of diabetes (≥12 years) after adjustment for age and sex. In cell culture, overexpression of miR-192 significantly downregulated KL mRNA and protein levels, and reduced KL levels in the media. miR-192 mimic reduced luciferase activity in a reporter containing the KL 3’ UTR (60% compared to controls, p

Background: The importance of leisure sedentary behavior (LSB) change in diabetes prevention efforts is not well known. This study examines the relationships between changes in self-reported LSB and the primary intervention goals (weight and moderate-intensity to vigorous-intensity physical activity [MVPA]) during a community-based translation of the Diabetes Prevention Program (the Group Lifestyle Balance Program). Methods: A total of 322 adults at risk for type 2 diabetes were recruited from 3 community centers, a worksite, and military site. Community and worksite participants were randomized to immediate or delayed-delivery (control) intervention. All military site participants (n = 99) received immediate intervention. Logistic and linear generalized estimating equations were used to determine associations between LSB changes and weight-related outcomes and MVPA. Results: Results were obtained for 259 (80.4%) participants. The LSB decreased after 6 and 12 months (mean [95% confidence interval]: −25.7 [−38.6 to −12.8] and −16.1 [−28.2 to −3.9] min/d; both P P = .042; adjusted model including MVPA), but LSB was not related to changes in reported MVPA minutes or MVPA goal achievement. Conclusion: Within the context of existing lifestyle intervention programs, reducing sedentary behavior has the potential to contribute to weight loss separately from reported MVPA improvement.

Background Group lifestyle sessions with phone maintenance could improve weight, health, and function in vulnerable older adults. Methods Community-dwelling adults (N = 322) with body mass index (BMI, kg/m2) ≥27 and additional risk factors received 12 one-hour in-person behavioral weight management group sessions then were randomized to 8 half-hour telephone sessions (n = 162) or newsletter control (n = 160) from 4 to 12 months with no treatment contact thereafter. Primary outcome was 0- to 12-month weight change. Cardiometabolic, short physical performance battery (SPPB), and self-reported activity changes were assessed at 12 and 24 months. Results At baseline, the mean (SD) age was 71.2 (4.3) and BMI was 33.8 (5.1). Participants were 77% women, 13% Black, 85% retired, averaging 4 medical conditions, and taking blood pressure (67.4%) and lipid-lowering (51.6%) medications. At 12 months, a greater proportion of the phone group (66.0%) achieved ≥5% weight loss compared with newsletter control (53.2%; p = .02). Mean (95% CI) weight loss was greater for phone (−6.6 kg [−7.5, −5.8]) than newsletter (−5.1 kg [−7.2, −3.0]); p = .01. Modest lipid, glucose, and blood pressure improvements were found, but did not differ significantly between groups. Small SPPB and activity improvements were maintained at 12 and 24 months in both groups. Conclusions Brief phone contacts compared to newsletters enhanced weight loss maintenance among older high-risk adults at 1 year, but not cardiometabolic outcomes. Modest functional improvements were observed in both. Lower-intensity maintenance contacts (phone or newsletter) for weight, health, and physical function in older adults warrant further study. Clinical Trials Registration Number NCT03192475

The ExoClock project is an inclusive, integrated, and interactive platform that was developed to monitor the ephemerides of the Ariel targets to increase the mission efficiency. The project makes the best use of all available resources, i.e., observations from ground telescopes, mid-time values from the literature and finally, observations from space instruments. Currently, the ExoClock network includes 280 participants with telescopes capable of observing 85\% of the currently known Ariel candidate targets. This work includes the results of $\sim$1600 observations obtained up to the 31st of December 2020 from the ExoClock network. These data in combination with $\sim$2350 mid-time values collected from the literature are used to update the ephemerides of 180 planets. The analysis shows that 40\% of the updated ephemerides will have an impact on future scheduling as either they have a significantly improved precision, or they have revealed biases in the old ephemerides. With the new observations, the observing coverage and rate for half of the planets in the sample has been doubled or more. Finally, from a population perspective, we identify that the differences in the 2028 predictions between the old and the new ephemerides have an STD that is double what is expected from gaussian uncertainties. These findings have implications for planning future observations, where we will need to account for drifts potentially greater than the prediction uncertainties. The updated ephemerides are open and accessible to the wider exoplanet community both from our Open Science Framework (OSF) repository and our website., Comment: 9 pages (47 with appendices and references), 8 figures, 2 tables. Submitted to ApJS. Revised based on the reviewer's comments

J.M.O. acknowledges financial support from the Portuguese Foundation for Science and Technology (FCT) and the European Social Fund (ESF) through the PhD grant SFRH/BD/131700/2017. The work leading to these results has received funding from the European Research Council under the European Community's H2020 2014-2021 ERC grant Agreement nffi 669416 "Lucky Star". We thank S. Para who supported some travels to observe the 5 October 2017 occultation. T.B. was supported for this research by an appointment to the National Aeronautics and Space Administration (NASA) Post-Doctoral Program at the Ames Research Center administered by Universities Space Research Association (USRA) through a contract with NASA. We acknowledge useful exchanges with Mark Gurwell on the ALMA CO observations. This work has made use of data from the European Space Agency (ESA) mission Gaia (https://www.cosmos.esa.int/gaia), processed by the Gaia Data Processing and Analysis Consortium (DPAC, https://www.cosmos.esa.int/web/gaia/dpac/consortium).Funding for the DPAC has been provided by national institutions, in particular the institutions participating in the Gaia Multilateral Agreement. J.L.O., P.S.-S., N.M. and R.D. acknowledge financial support from the State Agency for Research of the Spanish MCIU through the "Center of Excellence Severo Ochoa" award to the Instituto de Astrofisica de Andalucia (SEV-2017-0709), they also acknowledge the financial support by the Spanish grant AYA-2017-84637-R and the Proyecto de Excelencia de la Junta de Andalucia J.A. 2012-FQM1776. The research leading to these results has received funding from the European Union's Horizon 2020 Research and Innovation Programme, under Grant Agreement no. 687378, as part of the project "Small Bodies Near and Far" (SBNAF). P.S.-S. acknowledges financial support by the Spanish grant AYA-RTI2018-098657-J-I00 "LEO-SBNAF". The work was partially based on observations made at the Laboratorio Nacional de Astrofisica (LNA), Itajuba-MG, Brazil. The following authors acknowledge the respective CNPq grants: F.B.-R. 309578/2017-5; R.V.-M. 304544/2017-5, 401903/2016-8; J.I.B.C. 308150/2016-3 and 305917/2019-6; M.A. 427700/20183, 310683/2017-3, 473002/2013-2. This study was financed in part by the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior -Brasil (CAPES) -Finance Code 001 and the National Institute of Science and Technology of the e-Universe project (INCT do e-Universo, CNPq grant 465376/2014-2). G.B.R. acknowledges CAPES-FAPERJ/PAPDRJ grant E26/203.173/2016 and CAPES-PRINT/UNESP grant 88887.571156/2020-00, M.A. FAPERJ grant E26/111.488/2013 and A.R.G.Jr. FAPESP grant 2018/11239-8. B.E.M. thanks CNPq 150612/2020-6 and CAPES/Cofecub-394/2016-05 grants. Part of the photometric data used in this study were collected in the frame of the photometric observations with the robotic and remotely controlled telescope at the University of Athens Observatory (UOAO; Gazeas 2016). The 2.3 m Aristarchos telescope is operated on Helmos Observatory by the Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing of the National Observatory of Athens. Observations with the 2.3 m Aristarchos telescope were carried out under OPTICON programme. This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 730890. This material reflects only the authors views and the Commission is not liable for any use that may be made of the information contained therein. The 1. 2m Kryoneri telescope is operated by the Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing of the National Observatory of Athens. The Astronomical Observatory of the Autonomous Region of the Aosta Valley (OAVdA) is managed by the Fondazione Clement Fillietroz-ONLUS, which is supported by the Regional Government of the Aosta Valley, the Town Municipality of Nus and the "Unite des Communes valdotaines Mont-Emilius". The 0.81 m Main Telescope at the OAVdA was upgraded thanks to a Shoemaker NEO Grant 2013 from The Planetary Society. D.C. and J.M.C. acknowledge funds from a 2017 'Research and Education' grant from Fondazione CRT-Cassa di Risparmio di Torino. P.M. acknowledges support from the Portuguese Fundacao para a Ciencia e a Tecnologia ref. PTDC/FISAST/29942/2017 through national funds and by FEDER through COMPETE 2020 (ref. POCI010145 FEDER007672). F.J. acknowledges Jean Luc Plouvier for his help. S.J.F. and C.A. would like to thank the UCL student support observers: Helen Dai, Elise Darragh-Ford, Ross Dobson, Max Hipperson, Edward Kerr-Dineen, Isaac Langley, Emese Meder, Roman Gerasimov, Javier Sanjuan, and Manasvee Saraf. We are grateful to the CAHA, OSN and La Hita Observatory staffs. This research is partially based on observations collected at Centro Astronomico HispanoAleman (CAHA) at Calar Alto, operated jointly by Junta de Andalucia and Consejo Superior de Investigaciones Cientificas (IAA-CSIC). This research was also partially based on observation carried out at the Observatorio de Sierra Nevada (OSN) operated by Instituto de Astrofisica de Andalucia (CSIC). This article is also based on observations made with the Liverpool Telescope operated on the island of La Palma by Liverpool John Moores University in the Spanish Observatorio del Roque de los Muchachos of the Instituto de Astrofisica de Canarias with financial support from the UK Science and Technology Facilities Council. Partially based on observations made with the Tx40 and Excalibur telescopes at the Observatorio Astrofisico de Javalambre in Teruel, a Spanish Infraestructura Cientifico-Tecnica Singular (ICTS) owned, managed and operated by the Centro de Estudios de Fisica del Cosmos de Aragon (CEFCA). Tx40 and Excalibur are funded with the Fondos de Inversiones de Teruel (FITE). A.R.R. would like to thank Gustavo Roman for the mechanical adaptation of the camera to the telescope to allow for the observation to be recorded. R.H., J.F.R., S.P.H. and A.S.L. have been supported by the Spanish projects AYA2015-65041P and PID2019-109467GB-100 (MINECO/FEDER, UE) and Grupos Gobierno Vasco IT1366-19. Our great thanks to Omar Hila and their collaborators in Atlas Golf Marrakech Observatory for providing access to the T60cm telescope. TRAPPIST is a project funded by the Belgian Fonds (National) de la Recherche Scientifique (F.R.S.-FNRS) under grant PDR T.0120.21. TRAPPIST-North is a project funded by the University of Liege, and performed in collaboration with Cadi Ayyad University of Marrakesh. E.J. is a FNRS Senior Research Associate., Context. A stellar occultation by Neptune's main satellite, Triton, was observed on 5 October 2017 from Europe, North Africa, and the USA. We derived 90 light curves from this event, 42 of which yielded a central flash detection. Aims. We aimed at constraining Triton's atmospheric structure and the seasonal variations of its atmospheric pressure since the Voyager 2 epoch (1989). We also derived the shape of the lower atmosphere from central flash analysis. Methods. We used Abel inversions and direct ray-tracing code to provide the density, pressure, and temperature profiles in the altitude range similar to 8 km to similar to 190 km, corresponding to pressure levels from 9 mu bar down to a few nanobars. Results. (i) A pressure of 1.18 +/- 0.03 mu bar is found at a reference radius of 1400 km (47 km altitude). (ii) A new analysis of the Voyager 2 radio science occultation shows that this is consistent with an extrapolation of pressure down to the surface pressure obtained in 1989. (iii) A survey of occultations obtained between 1989 and 2017 suggests that an enhancement in surface pressure as reported during the 1990s might be real, but debatable, due to very few high S/N light curves and data accessible for reanalysis. The volatile transport model analysed supports a moderate increase in surface pressure, with a maximum value around 2005-2015 no higher than 23 mu bar. The pressures observed in 1995-1997 and 2017 appear mutually inconsistent with the volatile transport model presented here. (iv) The central flash structure does not show evidence of an atmospheric distortion. We find an upper limit of 0.0011 for the apparent oblateness of the atmosphere near the 8 km altitude., Portuguese Foundation for Science and Technology SFRH/BD/131700/2017, European Social Fund (ESF) SFRH/BD/131700/2017, European Research Council under the European Community's H2020 2014-2021 ERC grant 669416, Spanish Government SEV-2017-0709 AYA-2017-84637-R AYA-RTI2018-098657-J-I00, Junta de Andalucia 2012-FQM1776, European Union's Horizon 2020 Research and Innovation Programme, as part of the project "Small Bodies Near and Far" (SBNAF) 687378, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPQ), Fundacao de Apoio a Pesquisa do Distrito Federal (FAPDF) 309578/2017-5 304544/2017-5 401903/2016-8 308150/2016-3 305917/2019-6 427700/2018-3 310683/2017-3 473002/2013-2, Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) 001, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPQ) 465376/2014-2 CAPES-FAPERJ/PAPDRJ grant E26/203.173/2016 CAPES-PRINT/UNESP grant 88887.571156/2020-00, Fundacao Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio De Janeiro (FAPERJ) E26/111.488/2013, Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) 2018/11239-8, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPQ) 150612/2020-6, European Union's Horizon 2020 research and innovation programme 730890, Regional Government of the Aosta Valley, Town Municipality of Nus, Unite des Communes valdotaines Mont-Emilius, Planetary Society, Fondazione CRT-Cassa di Risparmio di Torino, Portuguese Foundation for Science and Technology PTDC/FISAST/29942/2017, FEDER through COMPETE 2020 POCI010145 FEDER007672, UK Research & Innovation (UKRI), Science & Technology Facilities Council (STFC), Fondos de Inversiones de Teruel (FITE), Spanish Government AYA2015-65041P PID2019-109467GB-100, Grupos Gobierno Vasco IT1366-19, Fonds de la Recherche Scientifique - FNRS PDR T.0120.21, University of Liege, CAPES/Cofecub-394/2016-05

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with no cure. Although the etiology of sporadic ALS is largely unknown, environmental exposures may affect ALS risk.We investigated relationships between exposure to long-term ambient particulate matter (PM) and gaseous air pollution (AP) and ALS mortality.Within the Women's Health Initiative (WHI) cohort of 161,808 postmenopausal women aged 50-79 years at baseline (1993-1998), we performed a nested case-control study of 256 ALS deaths and 2486 matched controls with emphasis on PM constituents (PMIn general, PMThis investigation adds to the body of information on long-term ambient AP exposure and ALS mortality. Specifically, the 2019 US Environmental Protection Agency (EPA) Integrated Science Assessment summarized the neurotoxic effects of PM

Background The Diabetes Prevention Program (DPP) behavioral lifestyle intervention was effective among a diverse sample of adults with prediabetes. Demonstrated effectiveness in translated versions of the DPP lifestyle intervention (such as Group Lifestyle Balance, DPP-GLB) led to widescale usage with national program oversight and reimbursement. However, little is known about the success of these DPP-translation programs across subgroups of sociodemographic factors. This current effort investigated potential disparities in DPP-translation program primary goal achievement (physical activity and weight) by key sociodemographic factors. Methods Data were combined from two 12-month community-based DPP-GLB trials among overweight/obese individuals with prediabetes and/or metabolic syndrome. We evaluated change in weight (kilograms and percent) and activity (MET-hrs/week) and goal achievement (yes/no; ≥5% weight loss and 150 min per week activity) after 6 and 12 months of intervention within and across subgroups of race/ethnicity (non-Hispanic white, non-Hispanic black), employment status, education, income, and gender. Results Among 240 participants (85%) with complete data, most sociodemographic subgroups demonstrated significant weight loss. However, non-Hispanic white lost more weight at both 6 and 12 months compared to non-Hispanic black participants [median weight loss (IQR), 6 months: 5.7% (2.7–9.0) vs. 1.5% (1.2–7.5) p = .01 and 12 months: 4.8% (1.1–9.6) vs. 1.1% (− 2.0–3.7) p = .01, respectively]. In addition, a larger percentage of non-Hispanic white demonstrated a 5% weight loss at 6 and 12 months. Employment was significantly related to 12-month weight loss, with retired participants being the most successful. Men, participants with graduate degrees, and those with higher income were most likely to meet the activity goal at baseline and 12 months. Differences in physical activity goal achievement across gender, education, and income groups were significant at baseline, attenuated after 6 months, then re-emerged at 12 months. Conclusions The DPP-GLB was effective in promoting weight loss and helped to alleviate disparities in physical activity levels after 6 months. Despite overall program success, differences in weight loss achievement by race/ethnicity were found and disparities in activity re-emerged after 12 months of intervention. These results support the need for intervention modification providing more tailored approaches to marginalized groups to maximize the achievement and maintenance of DPP-GLB behavioral goals. Trial registration NCT01050205, NCT02467881.

Purpose The purpose of this study was to examine how maintenance session attendance and 6-month weight loss (WL) goal achievement impacted 12-month 5% WL success in older adults participating in a community-based Diabetes Prevention Program (DPP) lifestyle intervention. Methods Data were combined from 2 community trials that delivered the 12-month DPP-based Group Lifestyle Balance (GLB) to overweight/obese adults (mean age = 62 years, 76% women) with prediabetes and/or metabolic syndrome. Included participants (n = 238) attended ≥4 core sessions (months 0-6) and had complete data on maintenance attendance (≥4 of 6 sessions during months 7-12) and 6- and 12-month WL (5% WL goal, yes/no). Multivariate logistic regression was used to estimate the odds of 12-month 5% WL associated with maintenance attendance and 6-month WL. Associations between age (Medicare-eligible ≥65 vs Results Both attending ≥4 maintenance sessions and meeting the 6-month 5% WL goal increased the odds of meeting the 12-month 5% WL goal. For those not meeting the 6-month WL goal, maintenance session attendance did not improve odds of 12-month WL success. Medicare-eligible adults ≥65 years were more likely to meet the 12-month WL goal (odds ratio = 3.03, 95% CI, 1.58-5.81) versus Conclusions The results of this study provide important information regarding participant attendance and WL for providers offering DPP-based lifestyle intervention programs across the country who are seeking Medicare reimbursement. Understanding Medicare reimbursement-defined success will allow these providers to focus on and develop strategies to enhance program effectiveness and sustainability.

INTRODUCTION: Lifestyle interventions promoting weight loss and physical activity are important elements of prevention efforts with the evaluation of program impact typically limited to weight loss. Unfortunately, diabetes/cardiovascular disease risk factors and activity are infrequently reported and inconsistent in findings when examined. This inconsistency may partially be due to a lack of consideration for ceiling effects because of broad risk profile inclusion criteria in community translation efforts. To demonstrate this, change in each individual cardiometabolic risk factor limited to those who, at baseline, had a clinically defined abnormal value for that risk factor was examined in 2 cohorts using identical community translations of the Diabetes Prevention Program lifestyle intervention. METHODS: For both studies (2010–2014, 2014–2019), adults with prediabetes and/or metabolic syndrome were recruited through community centers. Outcome measures collected at baseline and 6 months included BMI, activity, blood pressure, lipids, and fasting glucose. Data analyses examined pre–post change in each variable after 6 months of intervention and change within randomized groups at 6 months. RESULTS: Change results were examined for the entire cohort and separately for participants with baseline values outside the recommended range for that risk factor. Whether assessing the pre–post intervention change or change within the randomized groups at 6 months, often the risk factor–specific approach demonstrated a greater effect size for that variable and sometimes newly reached statistical significance. CONCLUSIONS: When examining the effectiveness of community translation efforts, consideration of the individual’s baseline profile with risk factor–specific analysis is suggested to understand the full extent of the impact of the intervention.

Purpose The purpose of this study was to evaluate the impact of a primary care (PC)-based delivery model on diabetes self-management education and support (DSMES) referrals and participation. Despite evidence that DSMES is a critical component of diabetes care, referrals and participation remain low. Methods PC practices were assigned to the intervention (n = 6) or usual care (n = 6). Intervention practices had direct access to a diabetes educator (DE) and applied patient-centered medical home elements to DSMES delivery. Usual care practices referred patients to traditional hospital-based outpatient DSMES programs. DSMES referrals and participation were examined for patients with diabetes, 18 to 75 years old, presenting to PC over 18 months (n = 4,894) and compared between groups. Results Compared to the usual care group, a higher percentage of patients in the intervention practices were referred to DSMES (18.4% vs 13.4%; P < .0001), and of those referred, a higher percentage of patients in the intervention practices participated in DSMES (34.9% vs 26.1%; P = .02). Patient-level factors predicting referrals were obesity (odds ratio [OR] = 1.6), higher A1C (OR = 1.4), female (OR = 1.3), and younger age (OR = 0.98). The only patient-level factor that predicted DSMES participation was lower A1C (OR = 0.9). Conclusions This study demonstrates the positive influence of a PC-based intervention on DSMES referral and participation. However, modest improvements in DSMES rates, even with targeted efforts to address reported barriers, raise questions as to what is truly needed to drive meaningful change.

Captive environments for snakes commonly involve small enclosures with dimensions that prevent occupants from adopting straight line body postures. In particular, the commercial, hobby, and pet sectors routinely utilize small vivaria and racking systems, although zoos and other facilities also commonly maintain at least some snakes under broadly similar conditions. Captive snakes may be the only vertebrates where management policy commonly involves deprivation of the ability and probable welfare need to freely extend the body to its natural full length. In this report, we present background information concerning some relevant physical and behavioral characteristics of snakes, discuss pervading beliefs or folklore husbandry and its implications for animal welfare as well as factors concerning stress, its manifestations and measurement, and provide criteria for the assessment of captive snake welfare. As part of this review, we also conducted an observational component involving captive snakes and report that during 60-minute observation periods of 65 snakes, 24 (37%) adopted rectilinear or near rectilinear postures (stationary 42%; mobile 37%). Of the 31 snake species observed, 14 (45%) adopted rectilinear or near rectilinear postures. Ectomorphological associations, normal behavior, and innate drive states infer that snakes, even so-called sedentary species, utilize significant space as part of their normal lifestyles. We conclude that future policies for snake husbandry require a paradigm shift away from an erroneous belief system and toward recognizing the greater spatial needs of these reptiles.

Cooling and freezing as methods for anesthetizing or cuthanizing amphibians and reptiles have been discussed since at least the late 1980s...

The DPP lifestyle intervention showed that meeting weight loss (WL) and activity goals can prevent/delay T2D. The success of community translated versions of it (e.g., Group Lifestyle Balance, DPP-GLB) has led to Medicare reimbursement based on session attendance (at 6 and 12 months) and participant success at meeting a 5% WL goal at 12 months. Although attendance has been suggested to be related to WL success, the impact of the 6 monthly maintenance sessions (mos 7-12) after the more frequent 16 core sessions (mos 0-6) on one-year WL is not known. This effort examines how maintenance session attendance and WL goal status at 6 months in DPP-GLB affects achievement of the 12-month 5% WL goal. Data were combined from two identical intervention trials that delivered the 12-month DPP-GLB in a community setting to overweight/obese adults (mean age 62 years, 76% women) with prediabetes and/or metabolic syndrome. Participants who attended ≥4 core sessions during the first 6 months and had complete data on maintenance attendance and WL were included (n=238). Meeting the 6-month WL goal was associated with greater odds of meeting the 12-month WL goal (p Disclosure J. Napoleone: None. R.G. Miller: None. S. Devaraj: None. B. Rockette-Wagner: None. V.C. Arena: None. E.M. Venditti: None. K. Kramer: None. A. Kriska: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R18DK100933, R18DK081323)

The Diabetes Prevention Program (DPP) and its translational adaptations have been shown to be effective. However, individual-level economic impacts, such as the out-of-pocket costs borne by participants due to involvement in these programs have not been consistently and thoroughly evaluated. As cost is an important consideration that will impact the willingness of individuals to participate in such programs, this study examined direct monetary costs to participants in the Group Lifestyle Balance (GLB) DPP. Older adults (n = 134, mean age 62.8 years) with body mass index (BMI) ≥24 kg/m2 and prediabetes and/or metabolic syndrome participated in this GLB intervention, with two-thirds randomized to begin the intervention immediately and one-third functioning as a control for 6 months before receiving the entire intervention. Food and activity time and costs borne by participants were measured by self-report at baseline and after 6 months. Significant improvements in clinical metabolic measures, weight, and physical activity levels were achieved after 6 months in the intervention group compared both with baseline and the controls. Food costs did not increase among intervention participants. Costs related to physical activity did not change consistently over the course of the intervention. This DPP–GLB lifestyle intervention was effective in reducing risk factors for Type 2 diabetes mellitus among a diverse group of older participants without significantly increasing their out-of-pocket costs for food or physical activity over the course of the intervention. These results should help reduce concerns of individuals who are hesitant to participate in similar programs due to costs. The clinical trial registration number of this study is NCT01050205.

Introduction: The AHA created “Life’s Simple Seven” metrics to measure progress toward the goal of improving the cardiovascular (CV) health of all Americans, classifying each metric as “ideal”, “intermediate,” or “poor”. Few studies have examined the impact of behavioral lifestyle interventions on CV health metrics. We evaluated changes in CV health metrics during the course of a CDC recognized Diabetes Prevention Program-based lifestyle intervention known as Group Lifestyle Balance (DPP-GLB). Hypothesis: DPP-GLB will be associated with improvements in CV health metrics after 6 months of intervention and maintenance of these improvements at 12 months post-baseline. Methods: We used combined data from two similar intervention trials (occurring 6 years apart) offering a 12 month DPP-GLB program in the community setting to overweight/obese individuals with prediabetes and/or metabolic syndrome. Changes in individual CV health metrics (BMI, blood pressure, total cholesterol, fasting blood glucose, physical activity; measures of smoking and diet were not available) and total metric score (sum of metric profile where ideal=2, intermediate=1 and poor=0 for each metric, possible “total “range of 0-10) were considered after 6 and 12 months of intervention. Results: Among 222 participants (76%) with complete data for all 5 metrics at intervention baseline, 6 and 12 month follow up, there was a significant beneficial shift from baseline to 6 and 12 months in the proportion of participants within CV health metric categories for BMI, physical activity and blood pressure (Figure 1). Total metric score also improved significantly (p Conclusions: The DPP-GLB intervention was successful in improving CV health metrics at both 6 and 12 months, demonstrating the potential of this program to decrease CVD risk.

Twinkle is an upcoming 0.45-m space-based telescope equipped with a visible and two near-infrared spectrometers covering the spectral range 0.4 to 4.5 μm with a resolving power R ∼ 250 (λ 2.42 μm). We explore Twinkle’s capabilities for small bodies science and find that, given Twinkle’s sensitivity, pointing stability, and spectral range, the mission can observe a large number of small bodies. The sensitivity of Twinkle is calculated and compared to the flux from an object of a given visible magnitude. The number, and brightness, of asteroids and comets that enter Twinkle’s field of regard is studied over three time periods of up to a decade. We find that, over a decade, several thousand asteroids enter Twinkle’s field of regard with a brightness and nonsidereal rate that will allow Twinkle to characterize them at the instrumentation’s native resolution with SNR > 100. Hundreds of comets can also be observed. Therefore, Twinkle offers researchers the opportunity to contribute significantly to the field of Solar System small bodies research.

Context Though the long-term consequences of celiac disease (CD) in type 1 diabetes are unclear, CD has been associated with increased prevalence of end-stage renal disease (ESRD) independent of type 1 diabetes. Objective We evaluated whether celiac autoimmunity is related to the cumulative incidence of microalbuminuria [albumin excretion rate (AER) 20 to 200 µg/min], macroalbuminuria (AER >200 µg/min), and ESRD. Design, patients, and methods In the prospective follow-up of the Pittsburgh Epidemiology of Diabetes Complications study of childhood-onset type 1 diabetes, 618 participants were screened for tissue transglutaminase (tTG) antibodies with a clinical assay. Nephropathy outcomes were determined at 25 years of diabetes duration. Results Overall, the 33 subjects (5.3%) with strongly positive tTG levels (≥3 times the upper limit of normal) or a reported clinical history of CD had lower baseline blood pressure and lipid values. At 25 years of diabetes duration, a lower cumulative incidence of macroalbuminuria in strongly positive subjects compared with those with negative serology (3.6% vs 30.0%; P = 0.003) remained significant after adjustment for age, HbA1c, lipid measures, and blood pressure (adjusted P = 0.004). No considerable differences between these subjects and tTG-negative groups were found for microalbuminuria (40.0% vs 57.1%) or ESRD (0 vs 4.1%). Conclusions These findings show that strongly positive celiac autoimmunity status in individuals with childhood-onset type 1 diabetes is associated with lower baseline blood pressure and cholesterol measurements as well as lower macroalbuminuria risk after 25 years of type 1 diabetes duration with no increase in the risk of microalbuminuria or ESRD.

Exotic pets are essentially animals that are non-native to a region and/or nondomesticated. The trade in and keeping of exotic pets has been frequently criticized for the commonly inhumane and harmful practices that are associated with supply and keeping, including animal welfare, species conservation, invasiveness, and public health and safety. Relatedly, a growing issue is that of unwanted exotic pets handed to animal care centers due to their overly demanding requirements and the confiscation of animals suffering from abuse. Mis-selling exotic species as "easy to keep" or "beginner" animals is widely regarded to be a major common and problematic factor. Efforts, after pet acquisition, to educate sellers and keepers to improve animal welfare and public health issues have proven unproductive. We propose that a system is required that facilitates decision-making at the interface between sale and purchase sectors and that uses clear evidence-based labeling. We review current options for developing such a pet labeling scheme and recommend a novel approach based on the EMODE ("easy," "moderate," "difficult," or "extreme") pet suitability assessment tool to provide a preventative educational approach to alleviating the multifactorial issues of concern.

Purpose The purpose of this study is to evaluate the feasibility and effectiveness of an adapted Diabetes Prevention Program (DPP) lifestyle program, DPP Group Lifestyle Balance (GLB), delivered in 3 economically diverse senior/community centers. Methods The DPP-GLB was implemented in 3 senior/community centers in Allegheny County, PA. A 6-month delayed control intervention design was used. Participants were randomized to begin the DPP-GLB immediately (immediate) or after a 6-month delay (delayed). Adults (n = 134; mean age = 62.8 years) with BMI ≥24 kg/m2 and prediabetes and/or the metabolic syndrome took part. Weight, physical activity (PA), and diabetes and cardiovascular disease (CVD) risk factors were assessed at 6, 12, and 18 months from baseline. Results At 6 months, the immediate group demonstrated greater mean weight loss than the delayed control group as well as significantly greater improvements in PA, A1C, fasting insulin, and waist circumference. In pre-post analyses, both randomized groups showed similar success that was maintained at 18 months. Conclusions The DPP-GLB delivered in economically diverse community centers was effective in this group of older adults. These findings support provision of coverage for prevention programs in older adults at risk for diabetes/CVD, which is important considering the large number of individuals who will be Medicare eligible in the near future.

Backgroun of this study is to investigate the PD-l1 expression in the Microenvironment of oral Squamous cell carcinoma (oScc) samples and its correlation to prognostic data.

the following review was performed to answer to the question “What is the rate of incidence of oral stomatitis in patients treated with VegF tKis?”

Purpose: Multiple studies have demonstrated significant disparities in the relationship between individual sociodemographic characteristics and risk of overweight or obesity. However, little information is available for assessing the complex associations among being overweight or obese with neighborhood and individual sociodemographic factors and the measured and perceived community food environment. Methods: Using 2014 national evaluation data from 20 communities (analyzed 2015–2016) that participated in the U.S. Centers for Disease Control and Prevention Community Transformation Grants Program, we used multilevel multivariable models to assess associations among factors at the individual, census tract, and county levels with being overweight or obese and with the perceived home food environment. Results: Individual level factors (age, sex, race/ethnicity, household income, and education) were significantly associated with the likelihood of being overweight or obese in every model tested. Census tract level poverty and education were significantly associated with the likelihood of being overweight or obese in univariate but not multivariable analyses. Perceived community food environment was a significant predictor of the perceived home food environment; the objective measure of county-level grocery store access was not. Neither perceived nor objective community food environment measures were significantly associated with overweight/obesity in multivariable analyses. Conclusion: Individual-level sociodemographic characteristics are more strongly associated with obesity-related outcomes than are area-level measures. Future interventions designed to address health equity issues in obesity among underserved populations may benefit from focusing on nutrition education tailored to individuals, to encourage purchase and consumption of healthy food. Improving healthy food availability in underserved communities may also be critical for nutrition education to have a meaningful impact.

The U.S. Diabetes Prevention Program (DPP) showed that lifestyle participants who achieved ≥7% weight loss and ≥150 min/week physical activity experienced the greatest reduction in type 2 diabetes incidence. Demographic, clinical, and program factors that are related to achieving both these lifestyle goals have seldom been explored in community-delivered DPP programs. The purpose of this investigation is to examine factors associated with concurrent achievement of weight loss and physical activity goals in a 12-month community DPP lifestyle intervention. Adults [n = 223; age = 58.4 (SD = 11.5); BMI = 33.8 (SD = 6.0)] with glucose or HbA1c values in the pre-diabetes range and/or metabolic syndrome risk factors enrolled from one worksite and three community centers in the Pittsburgh, PA metropolitan area between January 2011 and January 2014. Logistic regression analyses determined the demographic, clinical and program adherence factors related to goal achievement at 6, 12, and 18 months. Participants achieving both intervention goals at 6 months (n = 57) were more likely to attend sessions [Adjusted Odds Ratio (AOR) =1.48], self-weigh (AOR = 1.19), and self-monitor behaviors (AOR = 1.18) than those meeting neither goal (n = 35; all p

The natural history and mortality of type 1 diabetes in adolescents in Africa is not well characterized. Our aim is, therefore, to describe these characteristics for cases in the Rwanda Life For a Child (LFAC) program. Participants (≤25 years old) were the first 500 children and youth enrolled in the Rwanda LFAC program from 2004 to 2012. Clinical and demographic data were extracted from LFAC forms, and vital status was evaluated as of November 1, 2011. For the first 500 participants, 5-year survival was 93.8% while crude mortality was 13.9/1000 (95% CI 9.0–20.6/1000) person years of diabetes. However, since vital status is unknown for 134 participants, mortality could be as high as 40.2/1000 person years of diabetes if all missing cases died. Mortality was directly associated with age at diagnosis, and inversely to calendar year of first visit, BMI, and monitoring frequency. Hypertension prevalence reached 46% by 2012. Mortality rates associated with type 1 diabetes in Rwanda are similar to those in other African countries, but higher than rates in developed countries. Delayed diagnosis may contribute to excess mortality risk, but recent improvements in survival suggest that advancements are being made. Hypertension and loss to follow-up need to be addressed.

Purpose The purpose of this feasibility study was to determine the effectiveness of an insurer-based diabetes educator (DE)–driven intervention that relies on systematic restructuring of primary care (PC) linking DE services through population health, practice redesign, and coordinated care for patients with diabetes mellitus (DM) identified as high risk. Methods Two DEs were introduced as members of PC teams and worked with practice-based care managers (PBCMs) to identify and refer DM patients considered at high risk, A1C >9%, DM-related emergency room visit or hospitalization, or reported barriers to care. Elements shown to ensure quality, including population management, diabetes self-management education and support (DSMES), and coordinated patient-centered team-based PC, were central to intervention. A1C, low-density lipoprotein (LDL), and body mass index (BMI) were collected at baseline and outcomes were followed at 3, 6, 9, and 12 months after intervention. Results For patients who received intervention, A1C decreased on average 1.2% (95% confidence interval [CI], 0.8-1.5) from 9.6% (81 mmol/mol) to 8.4% (68 mmol/mol) over 6 months and by 1.1% (95% CI, 0.7-1.5) from 9.2% (77 mmol/mol) to 8.1% (65 mmol/mol) over 12 months, indicating durable improvement in glycemic control. There was no significant change in BMI, and LDL improvement observed at 9 months was lost by 12-month follow-up. Conclusion Findings support the feasibility of a DE-driven intervention for patients with DM at high risk through a coordinated PC approach that improves glycemic control. The feasibility and clinical outcome of this model warrant consideration of a fresh role for DEs in the complex environment of value-based care.

Despite evidence that DSME is a critical component of diabetes (DM) care, participation remains low. Innovative methods to improve attendance need to be explored. The purpose of this study was to evaluate the impact of a primary care (PC)-based DSME delivery model on DSME referrals and participation. Using a non-randomized design, diabetes educators (DEs) and PC practices were assigned to the intervention group (IG; 3 DEs, 6 practices) or control (CG; 2 DEs, 6 practices). IG practices applied patient-centered medical home elements to DSME delivery and had direct access to a DE. The CG employed traditional DSME delivery (PC patients referred to hospital-based DE). To examine DSME referrals and participation, medical record data were extracted for patients with DM, 18-75y, presenting to PC practices over 18 months (n=4,894; 59% IG, mean age 58.7y, 50.8% male) and compared between study groups. IG practices referred a higher percentage of patients to DSME compared to CG (18.4% v 13.4%; p Disclosure J. Krall: None. J. Kanter: None. K. Ruppert: None. V.C. Arena: None. F.X. Solano: None. L.M. Siminerio: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases

Terahertz-frequency quantum-cascade lasers (THz QCLs) are compact, electrically-driven sources of narrowband radiation in the ~2–5-THz band. Numerous scientifically important gas-phase species within the Earth’s upper atmosphere have distinctive spectral features within this band, making QCLs attractive sources for spectroscopic and radiometric atmospheric studies. In this paper, we demonstrate the integration of a QCL with a satellite-compliant cryocooler, precision-micromachined waveguide, a pair of diagonal feedhorns and a Cassegrain telescope, as key steps toward a complete 3.5-THz integrated receiver system.

Remote-sensing observations of Solar System objects with a space telescope offer a key method of understanding celestial bodies and contributing to planetary formation and evolution theories. The capabilities of Twinkle, a space telescope in a low Earth orbit with a 0.45-m mirror, to acquire spectroscopic data of Solar System targets in the visible and infrared are assessed. Twinkle is a general observatory that provides on-demand observations of a wide variety of targets within wavelength ranges that are currently not accessible using other space telescopes or that are accessible only to oversubscribed observatories in the short-term future. We determine the periods for which numerous Solar System objects could be observed and find that Solar System objects are regularly observable. The photon flux of major bodies is determined for comparison to the sensitivity and saturation limits of Twinkle's instrumentation and we find that the satellite's capability varies across the three spectral bands (0.4 to 1, 1.3 to 2.42, and 2.42 to 4.5 μm). We find that for a number of targets, including the outer planets, their large moons, and bright asteroids, the model created predicts that with short exposure times, high-resolution spectra (R ~ 250, λ < 2.42 μm; R ~ 60, λ > 2.42 μm) could be obtained with signal-to-noise ratio (SNR) of > 100 with exposure times of 10 would be achievable in 300 s (or less) for spectra at Twinkle's native resolution. Fainter or smaller targets (e.g., Pluto) may require multiple observations if resolution or data quality cannot be sacrificed. Objects such as the outer dwarf planet Eris are deemed too small, faint or distant for Twinkle to obtain photometric or spectroscopic data of reasonable quality (SNR > 10) without requiring large amounts of observation time. Despite this, the Solar System is found to be permeated with targets that could be readily observed by Twinkle.